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1.
Arq. bras. med. vet. zootec. (Online) ; 71(3): 944-952, May-June 2019. tab
Article in English | ID: biblio-1011295

ABSTRACT

It is important to identify the best inspired fraction of oxygen in a variety of situations, including sevoflurane or isoflurane anesthesia, in spontaneously breathing rabbits. For this, 64 rabbits were assigned to eight groups: GI100 (FiO2= 1,0 + isoflurane), GS100 (FiO2= 1,0 + sevoflurane), GI80 (FiO2= 0,8 + isoflurane), GS80 (FiO2= 0,8 + sevoflurane), GI60 (FiO2= 0,6 + isoflurane), GS60 (FiO2= 0,6 + sevoflurane), GI21 (FiO2= 0,21 + isoflurane), GS21 (FiO2= 0,21 + sevoflurane). The induction was performed with (2.5MAC) of the anesthetic. The vaporizer was setted at 1.5 MAC and FiO2 as attributed for each group. After the induction, the concentration was changed to 1 MAC. Measurements of parameters were performed 30 minutes after induction (T0), and then at 15 minute intervals (from T15 to T60). The arterial partial pressures of oxygen (PaO2), alveolar oxygen partial pressure (PAO2) and alveolar-arterial oxygen gradient [P(A-a)O2] were higher with the use of high FiO2. The GI80 showed higher levels of PaO2 FiO2 ratio and respiratory index (RI). In conclusion, the FiO2 of 0.21 is not indicated, because it causes hypoxemia. The isoflurane determines better ventilation when compared to sevoflurane, but isoflurane associated with 80% of oxygen promotes intrapulmonary shunt increase.(AU)


Tornou-se importante identificar a melhor fração inspirada de oxigênio em variadas situações, incluindo anestesia pelo sevoflurano ou isoflurano, em coelhos respirando espontaneamente. Para isso, 64 coelhos foram distribuídos em oito grupos: GI100 (FiO 2 = 1,0 + isoflurano), GS100 (FiO 2 = 1,0 + sevoflurano), GI80 (FiO 2 = 0,8 + isoflurano), GS80 (FiO 2 = 0,8 + sevoflurano), GI60 (FiO 2 = 0,6 + isoflurano), GS60 (FiO 2 = 0,6 + sevoflurano), GI21 (FiO 2 = 0,21 + isoflurano) e GS21 (FiO 2 = 0,21 + sevoflurano). A indução foi com 2,5 CAM do anestésico. Ajustou-se o vaporizador para 1,5 CAM, e a FiO 2 foi atribuída a cada grupo. Em seguida, a CAM foi reajustada para 1,0. Iniciaram-se as mensurações 30 minutos após a indução (M0), seguidas em intervalos de 15 minutos (de M15 a M60). As pressões parciais de oxigênio (PaO 2 ), a pressão parcial alveolar de oxigênio (P A O 2 ) e a diferença alvéolo-arterial de oxigênio [P(A-a)O 2 ] foram maiores com o emprego de altas FiO 2 . O GI80 apresentou maiores valores na relação entre PaO 2 e FiO 2 e índice respiratório (IR). Conclui-se que a FiO 2 0,21 não é indicada, pois provoca hipoxemia. No entanto, utilizada com isoflurano, determina melhor ventilação quando comparado ao sevoflurano, porém seu uso, associado a 80% de oxigênio, promove maior formação de shunt intrapulmonar.(AU)


Subject(s)
Animals , Rabbits/surgery , Oxygenation/methods , Anesthesia, Inhalation/veterinary , Isoflurane
2.
Rev. cuba. anestesiol. reanim ; 18(1): e489, ene.-abr. 2019. graf
Article in Spanish | LILACS, CUMED | ID: biblio-1093094

ABSTRACT

Introducción: Una serie de breves períodos de isquemias a distancia, previo al evento isquémico mayor, pueden limitar el daño miocárdico producido por la isquemia/reperfusión. Objetivo: Evaluar la utilidad del condicionamiento isquémico a distancia, en pacientes programados para procedimientos quirúrgicos de revascularización coronaria. Métodos: Se realizó un estudio cuasiexperimental, explicativo, comparativo con control histórico, en dos grupos de 247 pacientes, propuestos para revascularización coronaria. Se colocó un torniquete en el brazo derecho, en el grupo estudio, alternando 3 insuflaciones con 3 desinsuflaciones con una presión de 200 mmHg, manteniéndola 5 min cada una. Este proceder se realizó previo, durante y después del evento isquémico mayor, provocado por el pinzamiento de la arteria coronaria. Resultados: Se logró una disminución significativa de los parámetros enzimáticos. No se encontraron diferencias significativas (p>0,05) según un conjunto de variables que representan el estado inicial de los pacientes(AU)


Introduction: A series of short periods of distant ischemia, prior to the major ischemic event, can limit the myocardial damage produced by ischemia or reperfusion. Objective: To evaluate the usefulness of remote ischemic conditioning in patients scheduled for surgical procedures of coronary revascularization. Methods: A quasi-experimental, explanatory, comparative study with historical control was conducted in two groups of 247 patients proposed for coronary revascularization. A tourniquet was placed in the right arm in the study group, alternating 3 insufflations with 3 dessufflations with a pressure of 200 mmHg, keeping each for 5 minutes. This procedure was performed before, during and after the major ischemic event, caused by the impingement of the coronary artery. Results: A significant decrease in enzymatic parameters was achieved. No significant differences were found (p>0.05) according to a set of variables that represent the initial state of the patients(AU)


Subject(s)
Humans , Surgical Procedures, Operative/ethics , Ischemic Preconditioning/methods , Myocardial Revascularization/methods , Non-Randomized Controlled Trials as Topic , Anesthesia, Inhalation/methods
3.
Rev. cuba. anestesiol. reanim ; 17(2): 1-3, mayo.-ago. 2018.
Article in Spanish | LILACS, CUMED | ID: biblio-991021
4.
Article in Korean | WPRIM | ID: wpr-787335

ABSTRACT

Tidal volume by sevoflurane in small amounts is stable due to the increase in the breathing rate. But alveolus ventilation decreases due to sevoflurane as the degree of sedation increases; this ultimately causes PaCO2 to rise. The occurrence of suppression of breath increases the risk of severe hypoxia and hypercapnia in deeply sedated patients with disabilities. Sevoflurane inhalation anesthesia has a number of risks and may have unexpected problems with hemodynamic changes depending on the underlying state of the body. This study was conducted to examine the stability of internal acid-base system caused by respiratory depression occurring when patients with disabilities are induced by sevoflurane.Anesthetic induction was carried out by placing a mask on top of the patient's face and through voluntary breathing with 4 vol% of sevoflurane, 4 L/min of nitrous oxide, and 4 L/min of oxygen. After the patient's loss of consciousness and muscle relaxation, IV line was inserted by an expert and intravenous blood gas was analyzed by extracting blood from vein.In a deeply sedated state, the average amount of pH of the entire patients was measured as 7.36 ± 0.06. The average amount of PvCO₂ of the entire patients was measured as 48.8 ± 8.50 mmHg. The average amount of HCO₃₋ of the entire patients was measured as 27.2 ± 3.0 mmol/L.In conclusion, in dental treatment of patients with disabilities, the internal acid base response to inhalation sedation using sevoflurane is relatively stable.


Subject(s)
Anesthesia, General , Anesthesia, Inhalation , Hypoxia , Blood Gas Analysis , Hemodynamics , Humans , Hydrogen-Ion Concentration , Hypercapnia , Inhalation , Masks , Muscle Relaxation , Nitrous Oxide , Oxygen , Respiration , Respiratory Insufficiency , Tidal Volume , Unconsciousness , Veins , Ventilation
5.
Pesqui. vet. bras ; 37(10): 1133-1138, out. 2017. tab, ilus
Article in English | ID: biblio-895341

ABSTRACT

The objective of this study was to compare the influence of continuous intravenous infusion of tramadol alone, or tramadol combined with lidocaine and ketamine, on minimum alveolar concentration of sevoflurane (MACsevo) of dogs undergoing an ovariohysterectomy (OHE). We used 28 healthy dogs of various breeds and age, randomly divided into two groups according to the infusion given: TRA (tramadol alone) or TLK (tramadol, lidocaine and ketamine). The patients were premedicated with acepromazine and midazolam, and then anesthesia was induced with propofol and maintained with sevoflurane. Fifteen minutes after induction, the patients received their loading dose of treatment. Then, the continuous infusion was then set to 1.3mg/kg/hour of tramadol with or without 3mg/kg/hour of lidocaine and 0.6mg/kg/hour of ketamine, diluted in a 500mL bag of saline solution at an infusion rate of 10mL/kg/hour. The Dixon method was chosen to determine the MACsevo and a skin incision was used as a noxious stimulus. An unpaired Student's t-test was used to identify statistically significant differences between the treatments. These differences were considered significant when p<0.05. The MACsevo of the TRA group was 1.22±0.15 vol% and the MACsevo of the TLK group was 0.85±0.22 vol%. We conclude that TLK infusion decreased the MACsevo by 30.22% compared to tramadol alone, demonstrating that the combination of drugs was effective in reducing MACsevo in dogs.(AU)


O objetivo deste estudo foi comparar a influência da infusão contínua intravenosa do tramadol isolado e associado com lidocaína e cetamina, na concentração alveolar mínima de sevofluorano (CAMsevo) em cadelas submetidas à ovariosalpingohisterectomia. Foram utilizados 28 animais saudáveis de várias raças e idades, divididos aleatoriamente em dois grupos de acordo com a infusão adminstrada: TRA (tramadol) ou TLK (tramadol, lidocaína e cetamina). A medicação pré-anestésica foi realizada com acepromazina e midazolam, em seguida, a anestesia foi induzida com propofol e mantida com sevofluorano. Quinze minutos após a indução, os pacientes receberam um bolus do tratamento, com a infusão continua iniciada logo em seguida, sendo 1,3mg/kg/hora de tramadol, associado ou não a 3mg/kg/hora de lidocaína e 0,6mg/kg/hora de cetamina, diluidos em uma bolsa de solução salina de 500mL a uma taxa de infusão taxa de 10ml/kg/hora. O método de Dixon foi escolhido para determinar a MACsevo e a incisão na pele foi utilizada como o estímulo nocivo. O teste t de Student não pareado foi utilizado para identificar diferenças estatisticamente significativas entre os tratamentos. Estas diferenças foram consideradas significativas quando p<0,05. A CAMsevo do grupo TRA foi de 1,22±0,15vol% e a CAMsevo do grupo TLK foi de 0,85±0,22vol%. Conclui-se que a infusão de TLK diminuiu a CAMsevo em 30,22% em relação ao tramadol isolado, o que demonstra que a combinação de agentes analgésicos foi eficaz na redução do requerimento de sevofluorano em cães.(AU)


Subject(s)
Animals , Female , Dogs , Tramadol , Propofol , Dogs/surgery , Analgesia/veterinary , Anesthesia/veterinary , Anesthesia, Inhalation/veterinary , Ketamine , Anesthesia, Intravenous/veterinary , Lidocaine , Castration/veterinary
6.
ARS med. (Santiago, En línea) ; 42(3): 17-22, 2017. Tab
Article in Spanish | LILACS | ID: biblio-1017091

ABSTRACT

Introducción. La inducción anestésica con sevofluorano se asocia con agitación postanestésica (APA) en niños. Concentraciones de sevofluorano mayores a 6% producen actividad cerebral epileptiforme, la que podría estar relacionada a APA. El propósito de este estudio fue comparar el efecto de dos diferentes concentraciones de inducción anestésica con sevofluorano sobre la incidencia de APA, en niños sometidos a cirugía infraumbilical. Método. Estudio prospectivo y doble ciego, en pacientes de 2 a 7 años, operados de fimosis o hernia inguinal con anestesia general y bloqueo epidural caudal. Los pacientes fueron aleatorizados para recibir sevofluorano 5 por ciento (grupo S5) o sevofluorano 8 por ciento (grupo S8). Se registraron variables demográficas, signos vitales, profundidad anestésica utilizando índice biespectral (BIS) y respuesta motora durante distintos momentos de la anestesia. Se evaluó la presencia de agitación en pabellón y recuperación utilizando la escala de APA pediátrica (PAED). Análisis estadístico: t-test o Mann-Whitney y test Chi-cuadrado o Fisher, p < 0,05 considerada significativa. Resultados. Se reclutaron 33 pacientes, 16 en el grupo S5 y 17 en el grupo S8. Ambos grupos fueron comparables en cuanto a variables demográficas, signos vitales, respuesta motora y valores de BIS. No hubo diferencias significativas en la incidencia de APA en pabellón (S5: 31,3 por ciento y S8: 35,3 por ciento) y en recuperación (S5: 43,8 por ciento y S8: 41,2 por ciento), entre los grupos. Conclusión. No habría relación entre la concentración de inducción anestésica de sevofluorano y la incidencia de APA en niños sometidos a cirugía infraumbilical con anestesia general y bloqueo caudal. (AU)


Introduction. Induction of anesthesia with sevoflurane is associated with post-anesthetic agitation (PAA) in children. Sevoflurane concentration greater than 6% produces epileptiform brain activity, which could be related to PAA. The aim of this study was to compare the effect of two different sevoflurane concentrations for anesthesia induction on the incidence of PAA in children undergoing infraumbilical surgery. Method. Prospective, double blind study, performed in patients 2 to 7 years of age, undergoing circumcision or inguinal hernia repair under general anesthesia and epidural caudal block. Patients were randomized to receive sevoflurane 5 percent (S5 group) or sevoflurane 8 percent (S8 group), during anesthesia induction. Demographic variables, vital parameters, anesthesia depth using bispectral index (BIS) and motor responses during different moments of anesthesia were recorded. The presence of agitation in the operating room and recovery room were determined using the pediatric PAA scale (PAED). Statistical analysis: t-test or Mann-Whitney, and Chi-square or Fisher test, p < 0.05 considered significant. Results. Thirty-three patients were enrolled, 16 in the S5 group and 17 in the S8 group. Demographic variables, vital parameters, motor responses and BIS values were comparable between both groups. There were no significant differences in the incidence of PAA in the operating room (S5: 31.3 percent percent and S8: 35.3 percent) or in the recovery room (S5: 43,8 percent and S8: 41.2 percent), between both groups. Conclusion. Sevoflurane concentration used for induction of anesthesia would not be related to the incidence of PAA in children undergoing infraumbilical surgery under general anesthesia and epidural caudal block. (AU)


Subject(s)
Humans , Male , Female , Child , Deep Sedation , Emergence Delirium , Child , Anesthesia, Inhalation
7.
Article in Korean | WPRIM | ID: wpr-649652

ABSTRACT

Temporomandibular joint (TMJ) pain is characterized by persistent jaw pain associated with dysfunction and tenderness of the temporomandibular muscles and joints. The aim of this study was to investigate whether treatment with red or black ginseng extract helps in the modulation of inflammatory TMJ pain. Male Sprague-Dawley rats weighing 220~260 g were used. The experimental group was subdivided into 4 groups based on the treatment method (n=6, each group): formalin (5%, 30 µl), formalin after distilled water (vehicle), formalin after red or black ginseng extract (per oral, single or repeated, respectively). To induce TMJ pain, 30 µl of formalin was injected into the articular cavity under ether inhalation anesthesia. The number of noxious behavioral responses of scratching the facial region proximal to the injection site was recorded for 9 successive 5-min intervals following formalin injection. Repeated treatment with red or black ginseng extract reduced the nociceptive responses in the second phase (11~45 min). Nuclear factor erythroid 2-related factor 2 (Nrf2) is an oxidative stress-mediated transcription factor. Both ginsengs significantly down-regulated the increased Nrf2 level compared to the vehicle group. In the test for liver and kidney functions, repeated treatment with red or black ginseng was not different compared to the vehicle group. These results indicate that red and black ginseng extract might be promising analgesic agents in the treatment of inflammatory TMJ pain.


Subject(s)
Analgesics , Anesthesia, Inhalation , Animals , Ether , Formaldehyde , Humans , Jaw , Joints , Kidney , Liver , Male , Methods , Models, Animal , Muscles , Panax , Rats , Rats, Sprague-Dawley , Temporomandibular Joint , Transcription Factors , Water
8.
Article in English | WPRIM | ID: wpr-76819

ABSTRACT

Cleft palate is one of the most common congenital malformations of the oral and maxillofacial region, with an incidence rate of around 0.1%. Early surgical repair is the only method for treatment of a cleft lip and palate. However, because of the use of inhalation anesthesia in children and the physiological characteristics of the cleft palate itself combined with the particularities of cleft palate surgery, the incidence rate of postoperative emergence agitation (EA) in cleft palate surgery is significantly higher than in other types of interventions. The exact mechanism of EA is still unclear. Although restlessness after general anesthesia in children with cleft palate is self-limiting, its effects should be considered by clinicians. In this paper, the related literature on restlessness after surgery involving general anesthesia in recent years is summarized. This paper focuses on induction factors as well as prevention and treatment of postoperative restlessness in children with cleft palate after general anesthesia. The corresponding countermeasures to guide clinical practice are also presented in this paper.


Subject(s)
Anesthesia, General , Anesthesia, Inhalation , Child , Cleft Lip , Cleft Palate , Dihydroergotamine , Humans , Incidence , Methods , Palate , Psychomotor Agitation
9.
Arq. bras. med. vet. zootec ; 68(6): 1613-1620, nov.-dez. 2016. tab, ilus
Article in Portuguese | LILACS, VETINDEX | ID: biblio-827943

ABSTRACT

O objetivo deste trabalho foi descrever os achados eletrocardiográficos de 11 onças- pardas (Puma concolor). Os animais foram sedados com 0,15mg/kg de detomidina associado a 5mg/kg de cetamina e mantidos anestesiados com sevoflurano (GSEVO, n=6) ou isoflurano (GISO, n=5). A frequência cardíaca foi de 95 ± 13bpm. As alterações observadas nos animais no GSEVO foram: atrial standtill com condução ventricular, episódios isolados de contração ventricular prematura, bloqueio atrioventricular de primeiro grau, diminuição da amplitude do complexo QRS, onda S profunda e aumento da amplitude da onda T. No grupo GISO, observou-se bloqueio de ramo direito do feixe de His, bloqueio atrioventricular de primeiro grau e aumento da amplitude da onda T. Arritmias não puderam ser associadas ao uso dos anestésicos inalatórios devido à não sensibilização do miocárdio às catecolaminas. Achados como o BAV de primeiro grau pode ter ocorrido devido ao uso de agonistas alfa-2 adrenérgicos. Este estudo aumentou o conhecimento sobre as alterações eletrocardiográficas em onças-pardas anestesiadas, entretanto mais estudos são necessários para correlacionar estes achados ao uso de agentes anestésicos.(AU)


The aim of this study was to describe electrocardiographic findings in pumas (Puma concolor). The animals were sedated with 0.15mg/kg of detomidine plus 5mg/kg of ketamine and anesthetized with sevoflurane (GSEVO, n=6), or isoflurane (GISO, n=5). The heart rate was 95 ± 13bpm. The changes observed on GSEVO animals were: atrial standstill with ventricular conduction, isolated episodes of ventricular premature contraction, atrioventricular blockage of first degree, reduction of the amplitude of the QRS complexes, deep S wave, and increase of the amplitude of the T wave. In the GISO group a right bundle branch block of the His bundle, atrioventricular blockage of first degree and of the amplitude of the T wave. Arrhythmias couldn´t be related to the use of inhalant anesthesia due to the lack of myocardial awareness to catecholamines. Findings such as atrioventricular block in first degree may have occurred due to the use of alfa-2 adrenergic agonists. This study improved the knowledge about electrocardiographic alterations in anesthetized pumas, however further studies are required to correlate these findings to the use of anesthetic agents.(AU)


Subject(s)
Animals , Anesthesia, Inhalation/veterinary , Electrocardiography , Heart Rate/drug effects , Puma , Anesthesia, General/veterinary , Isoflurane
10.
Anest. analg. reanim ; 29(2): 1-17, dic. 2016. tab, graf
Article in Spanish | LILACS | ID: biblio-949971

ABSTRACT

Resumen: La Hipertermia Maligna (HM), es un síndrome clínico que ocurre en pacientes susceptibles tras la exposición a un agente anestésico desencadenante. La mortalidad desciende con tratamiento específico, por lo que es fundamental su diagnóstico y tratamiento precoz. Se presenta el caso clínico de una niña de 3 años y 10 meses, en estudio por hemiparesia derecha de 3 meses de evolución. Se plantea probable enfermedad desmielinizante. Se le realizaron dos resonancias magnéticas (RNM) previas con anestesia sin incidentes. Por mala evolución de su enfermedad, se realiza nueva RNM con anestesia. A las 5 horas presenta episodio de distonías, acidosis, CPK elevada. Se interpreta como HM, se inicia tratamiento para la misma con mejoría del cuadro clínico. Presentamos este caso con el objetivo de exponer un enfoque diagnóstico y terapéutico de esta patología.


Summary: Malignant Hyperthermia (MH)is a clinical syndrome that occurs in susceptible patients after exposure to a triggering anesthetic agent. Associated mortality decreases with specific treatment, which is why its diagnosis and early treatment is essential. We present the case of a 3-year and 10-month-old girl, who presented a right hemiparesis. Possible demyelinating disease was suspected. Two previous magnetic resonance imaging (MRI) were performed under general anesthesia without complications. Due to poor evolution of his disease, new MRI is performed with anesthesia. After the procedure, she presented an episode of dystonias, acidosis, elevated CPK. It was interpreted as MH, and specific treatment was initiated instated. We present this case with the objective of exposing a diagnostic and therapeutic approach to this pathology.


Resumo: A hipertermia maligna (HM), è uma sindrome clinica que ocorre em pacientes sucetíveis devido a exposição a um agente anestésico desencadeante. A mortalidade diminui com tratamento específico, para o qual é fundamental diagnostico e tratamento precoce. Apresenta-se um caso clínico de uma criança de 3 anos e 10 meses de idade, em estudo por hemiparesia direita de 3 meses de evolução. Questiona-se provável doença desmielinizante. Foram realizadas duas ressonância magnéticas (RNM) previas, sob anestesia, sem incidentes. Devido à má evolução de sua doença, realizuo-se nova RNM sob anestesia. Cinco horas após apresentou episódios de rigidez muscular, acidose e CPK elevada. Interpretou-se como HM, iniciando-se tratamento específico, obtém-se melhoria do quadro clínico. Apresentamos este caso clínico com o objetivo de expor um enfoque diagnóstico e terapêutico desta patologia.


Subject(s)
Humans , Dantrolene , Anesthesia, Inhalation/adverse effects , Malignant Hyperthermia , Malignant Hyperthermia/diagnosis , Malignant Hyperthermia/etiology , Tachycardia, Sinus , Diagnosis, Differential
11.
Arq. bras. med. vet. zootec ; 68(2): 369-378, mar.-abr. 2016. tab
Article in Portuguese | LILACS | ID: lil-779772

ABSTRACT

Avaliou-se a eficácia e a segurança anestésica em ovinos mantidos sob anestesia geral inalatória com isofluorano ou anestesia total intravenosa com propofol, ambas associadas à anestesia subaracnoidea. Quatorze ovinos foram pré-medicados com 0,3mg.kg-1 de morfina IM, e cinco minutos após, receberam 20mcg.kg-1 de detomidina IV. Posteriormente, foram alocados aleatoriamente em dois grupos: GISO (n=7), os quais foram induzidos à anestesia geral com 0,5mg.kg-1 de diazepam e 5mg.kg-1 de cetamina IV, e mantidos em anestesia geral inalatória com isoflurano diluído em oxigênio a 100%; e GPRO (n=7), induzidos com 4mg.kg-1 de propofol IV seguido inicialmente de infusão contínua na taxa de 0,3mg.kg-1.min-1. Para realização da osteotomia bilateral, todos os animais receberam 0,5mg.kg-1 de ropivacaína 0,75% associado a 0,1mg.kg-1 de morfina pela via subaracnoidea. Houve redução de 40% nos valores médios de frequência cardíaca após sedação em ambos os grupos, permanecendo em média 23% reduzida até o final da avaliação. A pressão arterial média aumentou 16%, após a indução anestésica no GISO, mas se reduziu até o final do procedimento, assim como no GPRO. A EtISO média foi de 0,57V% e a taxa média de infusão do propofol foi de 0,24mg.kg-1.min-1. Os tempos totais de cirurgia, anestesia e extubação foram de 66±9,8, 92±13,8 e 7,0±1,5 minutos no GISO e 56±2,4, 82,9±4,6 e 5,4±1,5 minutos no GPRO, não havendo diferença significativa entre grupos. A manutenção anestésica com isoflurano ou propofol promoveu plano anestésico similar com mínimos efeitos cardiovasculares ou hemogasométricos, que são bem tolerados em ovinos hígidos.


The purpose of this study was to evaluate the efficacy and safety of sheep submitted to inhalation anesthesia with isoflurane or total intravenous anesthesia with propofol, both associated with subarachnoid anesthesia. Fourteen animals were pre-medicated with 0.3mg.kg-1 morphine IM, and 5 minutes later received 20mcg.kg-1 detomidine IV. Then they were allocated into two groups: GISO (n=7), which were induced with 0.5mg.kg-1 of diazepam and 5mg.kg-1 of ketamine IV, and anesthesia maintenance was performed by isoflurane diluted in 100% oxygen; or GPRO (n=7), where animals were induced with 4mg.kg-1 propofol IV and subsequent maintenance anesthesia with its own infusion of 0.3mg.kg.min-1. To perform the bilateral tibial osteotomy, all animals received 0.5mg.kg-1 0.75% ropivacaine combined with 0.1mg.kg-1 morphine by the intrathecal route. There was a 40% reduction in mean heart rate after the sedative protocol in both groups, resulting in a 23% average reduction until the end of the review. Mean arterial pressure showed transient elevation of around 16%, after induction of anesthesia in GISO, but reducing it to the end of the procedure, as well as in GPRO. The average EtISO was 0.57 V% and average infusion rate of propofol was 0.24mg.kg-1.min-1. The total time of surgery, anesthesia and extubation was 66± 9.8, 92±7.0 and 13.8±1.5 minutes in GISO and 56±2.4, 82.9±4.6 and 5.4±1.5 minutes in GPRO. The maintenance of anesthesia with propofol or isoflurane produced similar anesthesia with minimal cardiovascular and blood gas effects, which are well tolerated in healthy sheep.


Subject(s)
Animals , Balanced Anesthesia/veterinary , Anesthesia, General/veterinary , Anesthesia, Intravenous/veterinary , Anesthesia, Inhalation/veterinary , Sheep , Anesthesiology , Anesthetics , Isoflurane , Propofol
12.
Pesqui. vet. bras ; 36(1): 33-38, Jan. 2016. tab
Article in English | LILACS | ID: lil-777378

ABSTRACT

The aim of this study was to assess the cardiopulmonary effects, the onset time after the administration of a detomidine/ketamine combination, and the recovery from anesthesia of cougars (Puma concolor) anesthetized with detomidine/ketamine and isoflurane or sevoflurane for abdominal ultrasound imaging. Fourteen animals were randomly allocated into two experimental groups: GISO (n=7) and GSEVO (n=7). Chemical restraint was performed using 0.15mg/kg detomidine combined with 5mg/kg ketamine intramuscularly; anesthesia induction was achieved using 2mg/kg propofol intravenously and maintenance with isoflurane (GISO) or sevoflurane (GSEVO). The following parameters were assessed: heart rate, respiratory rate, systolic and diastolic arterial blood pressure, mean arterial blood pressure, oxyhemoglobin saturation, rectal temperature, central venous pressure, and end-tidal carbon dioxide. The time to sternal recumbency (TSR) and time to standing position (TSP) were also determined. There was not statistically significant difference for the cardiopulmonary variables or TSP whereas TSR was significantly shorter in GSEVO. The time to onset of anesthesia was 11.1±1.2 minutes and 11.3±1.8 minutes for GISO and GSEVO, respectively. The anesthesia of cougars with detomidine/ketamine and isoflurane or sevoflurane was conducted with safety, cardiopulmonary stability, and increased time to sternal recumbency in the GISO group.


O objetivo do presente estudo foi avaliar os efeitos cardiorrespiratórios e a recuperação anestésica de onças-pardas (Puma concolor) submetidas à anestesia com detomidina/cetamina e isofluorano ou sevofluorano para avaliação ultrassonográfica abdominal. Para isso, foram utilizados 14 animais divididos aleatoriamente em dois grupos experimentais GISO (n=7) e GSEVO (n=7). Foram submetidos à contenção química com detomidina 0,15mg/kg associada à cetamina 5mg/kg pela via intramuscular, induzidos com propofol 2mg/kg pela via intravenosa e mantidos com isofluorano (GISO) ou sevofluorano. Foram avaliados os parâmetros: frequência cardíaca e respiratória, pressão arterial sistólica, média e diastólica saturação de oxihemoglobina, temperatura retal, pressão venosa central e fração expirada de dióxido de carbono. O tempo para adoção de decúbito esternal e posição quadrupedal também foram avaliados. Não houve diferença estatística para as variáveis cardiorrespiratórias e no tempo para adoção da posição quadrupedal. O tempo para adoção de decúbito esternal foi significativamente menor no GSEVO em relação ao GISO. Concluiu-se que a anestesia de onças pardas com detomidina/cetamina e isoflurano ou sevoflurano foi realizada de maneira segura, com estabilidade cardiorrespiratória e com aumento no tempo para adoção de decúbito esternal no GISO.


Subject(s)
Animals , /analysis , Anesthesia, Inhalation/veterinary , Isoflurane , Ketamine , Puma/metabolism , Respiratory Rate , Animals, Wild/metabolism , Diagnostic Techniques, Cardiovascular/veterinary
14.
Article in English | WPRIM | ID: wpr-41326

ABSTRACT

BACKGROUND: Anesthetic agents used for general anesthesia are emerging possible influential factors for surgical site infection (SSI). In this retrospective study, we evaluated the incidence of SSI after colorectal surgery according to the main anesthetic agents: volatile anesthetics vs. propofol. METHODS: A total 1,934 adult patients, who underwent elective colorectal surgery under general anesthesia between January 2011 and December 2013, were surveyed to evaluate the incidence of SSI: 1,519 using volatile anesthetics and 415 using propofol for main anesthetic agents. Patient, surgery, and anesthesia-related factors were investigated from all patients. Propensity-score matching was performed to reduce the risk of confounding and produced 390 patients in each group. RESULTS: Within the propensity-score matched groups, the incidence of SSI was higher in the volatile group compared with the propofol group (10 [2.6%] vs. 2 [0.5%], OR = 5.0 [95% CI = 1.1-2.8]). C-reactive protein was higher in the volatile group than in the propofol group (8.4 ± 5.6 vs. 7.1 ± 5.3 mg/dl, P = 0.001), and postoperative white blood cells count was higher in the volatile group than in the propofol group (9.2 ± 3.2 × 10³/µl vs. 8.6 ± 3.4 × 10³/µl, P = 0.041). CONCLUSIONS: The results of this study suggest that intravenous anesthesia may have beneficial effects for reducing SSI in colorectal surgery compared to volatile anesthesia.


Subject(s)
Adult , Anesthesia , Anesthesia, General , Anesthesia, Inhalation , Anesthesia, Intravenous , Anesthetics , C-Reactive Protein , Colorectal Surgery , Humans , Incidence , Leukocytes , Propofol , Research Design , Retrospective Studies , Surgical Wound Infection
15.
Rev. bras. enferm ; 68(4): 705-712, jul.-ago. 2015. ilus
Article in Portuguese | LILACS, BDENF | ID: lil-761098

ABSTRACT

RESUMOObjetivo:caracterizar a produção científica dos Programas de Pós-Graduação em Enfermagem do Brasil, sobre promoção da saúde com enfoque nas pessoas idosas em condição crônica, no período de 2006 a 2010.Método:pesquisa integrativa, realizada através da busca de dissertações e teses da base de dados do Centro de Estudos e Pesquisas em Enfermagem da Associação Brasileira de Enfermagem, publicados no período de 2006 a 2010, que focassem a promoção de saúde de idosos em condição crônica.Resultados:emergiram cinco categorias temáticas: "Convívio com a doença"; "Tecnologias de cuidado"; "Potencialidades para o autocuidado" "Dimensão psicoespiritual" e "Família cuidadora".Conclusão:pôde-se identificar a assistência de enfermagem como elemento fundamental para promover a saúde do indivíduo idoso e torná-lo mais independente de cuidados para conviver com suas limitações ou incapacidades, mesmo acometido por doenças crônicas.


RESUMENObjetivo:caracterizar la producción científica de la Postgraduate Nursing Brasil, en la promoción de la salud con especial atención a las personas mayores con enfermedades crónicas en el período 2006-2010.Método:la investigación integral realizada mediante la búsqueda de disertaciones y tesis en la base de datos del Centro de Estudios e Investigación en Enfermería Asociación Brasileña de Enfermería, publicada en el período 2006-2010, que se centrará en la promoción de la salud para las personas mayores con enfermedades crónicas.Resultados:cinco temas emergieron: "La convivencia con la enfermedad", "cuidado Technologies", "potencial para el propio cuidado" "dimensión psico-espiritual" y "cuidador familiar".Conclusión:se pudo identificar el cuidado de enfermería como un elemento clave para promover la salud de las personas mayores y que sea una atención más independiente que vivir con limitaciones o incapacidades, aún afectados por enfermedades crónicas.


ABSTRACTObjective:to characterize the scientific production of Postgraduate Programs Nursing in Brazil on health promotion with a focus on elderly people with chronic conditions in the period from 2006 to 2010.Method:integrative research developed by searching for dissertations and theses in the database of the Center for Nursing Studies and Research of the Brazilian Nursing Association published in the period from 2006 to 2010 and which focused on health promotion for elderly people with chronic conditions.Results:five themes emerged: "Living with the disease"; "Technologies of care", "Potential for self-care" "Psycho-spiritual dimension", and "Family caregiver".Conclusion:it was possible to identify nursing care as a key element to promote the health of elderly people and make them more independent in their care so as to live with their limitations or disabilities, even when affected by chronic diseases.


Subject(s)
Animals , Male , Female , Anesthetics, Inhalation , Anesthesia, Inhalation/veterinary , Cardiac Output/drug effects , Horses/physiology , Isoflurane , Muscle Relaxants, Central/pharmacology , Thermodilution/veterinary , Xylazine/pharmacology , Cardiac Output/physiology
16.
Int. braz. j. urol ; 41(3): 466-472, May-June 2015. tab, ilus
Article in English | LILACS | ID: lil-755882

ABSTRACT

ABSTRACTObjectives:

To compare the effects of CO2 insufflation on hemodynamics and oxygen levels and on acid-base level during Robot-Assisted Radical Prostatectomy (RARP) with transperitoneal (TP) versus extra-peritoneal (EP) accesses.

Materials and Methods:

Sixty-two patients were randomly assigned to TP (32) and EP (30) to RARP. Pre-operation data were collected for all patients. Hemodynamic, respiratory and blood acid-base parameters were measured at the moment of induction of anesthesia (T0), after starting CO2 insuffation (T1), and at 60 (T2) and 120 minutes (T3) after insufflation. In all cases, the abdominal pressure was set at 15 mmHg. Complications were reported according to the Clavien-Dindo classification. Student's two–t-test, with a significance level set at p<0.05, was used to compare categorical values between groups. The Mann-Whitney U-test was used to compare the median values of two nonparametric continuous variables.

Results:

The demographic characteristics of the patients in both groups were statistically comparable. Analysis of intra-operative anesthesiologic parameters showed that partial CO2 pressure during EP was significantly higher than during TP, with a consequent decrease in arterial pH. Other parameters analysed were similar in the two groups. Postoperative complications were comparable between groups. The most important limitations of this study were the small size of the patient groups and the impossibility of maintaining standard abdominal pressure throughout the operational phases, despite attempts to regulate it.

Conclusions:

This prospective randomized study demonstrates that, from the anesthesiologic viewpoint, during RARP the TP approach is preferable to EP, because of lower CO2 reabsorption and risk of acidosis.

.


Subject(s)
Aged , Animals , Humans , Male , Middle Aged , Anesthesia, Inhalation/methods , Carbon Dioxide/metabolism , Hemodynamics/drug effects , Prostatectomy/methods , Prostatic Neoplasms/surgery , Robotic Surgical Procedures/methods , Neoplasm Grading , Operative Time , Prospective Studies , Peritoneum/surgery , Prostatic Neoplasms/pathology , Reproducibility of Results , Risk Factors , Statistics, Nonparametric , Time Factors , Treatment Outcome
17.
Pesqui. vet. bras ; 35(1): 95-98, 01/2015. tab, graf
Article in English | LILACS | ID: lil-746559

ABSTRACT

The study aimed to compare the effects of intraosseous infusion of lactated Ringer's and 0.9% sodium chloride solutions on the electrolytes and acid-base balance in pigeons submitted to humerus osteosynthesis. Eighteen pigeons were undergoing to isoflurane anesthesia by an avalvular circuit system. They were randomly assigned into two groups (n=9) receiving lactated Ringer's solution (LR) or 0.9% sodium chloride (SC), in a continuous infusion rate of 20mL/kg/h, by using an intraosseous catheter into the tibiotarsus during 60-minute anesthetic procedure. Heart rate (HR), and respiratory rate (RR) were measured every 10 min. Venous blood samples were collected at 0, 30 and 60 minutes to analyze blood pH, PvCO2, HCO3 -, Na+ and K+. Blood gases and electrolytes showed respiratory acidosis in both groups during induction, under physical restraint. This acidosis was evidenced by a decrease of pH since 0 min, associated with a compensatory response, observed by increasing of HCO3 - concentration, at 30 and 60 min. It was not observed any changes on Na+ and K+ serum concentrations. According to the results, there is no reason for choosing one of the two solutions, and it could be concluded that both fluid therapy solutions do not promote any impact on acid-base balance and electrolyte concentrations in pigeons submitted to humerus osteosynthesis...


O presente estudo avaliou os efeitos da infusão das soluções de Ringer lactato ou cloreto de sódio 0,9%, no equilíbrio ácido-base e hidroeletrolítico de pombos submetidos à osteossíntese de úmero. Foram utilizados 18 animais, os quais foram submetidos à anestesia por isofluorano, e mantidos em circuito avalvular durante o período anestésico (60 min). Os animais foram distribuídos aleatoriamente em dois grupos (n=9) recebendo Ringer lactato (LR) ou cloreto de sódio 0,9% (SC), administradas na taxa de 20mL/kg/h pela via intraóssea (tibiotarso). Foram monitoradas as frequências cardíaca e respiratória a cada 10 minutos e colhidas amostras sanguíneas venosas aos 0, 30 e 60 min de anestesia, obtendo-se a partir destas, valores de pH sanguíneo, bicarbonato (HCO3), pressão venosa de CO2 (PvCO2), sódio (Na+) e potássio (K+). Os valores referentes ao equilíbrio ácido-base indicam que houve acidose respiratória em ambos os grupos, a qual foi decorrente do processo de indução sob contenção física, caracterizada por diminuição no pH desde o 0 min, associado ao aumento compensatório nos valores de HCO3 -, nos momentos 30 e 60 min. No entanto, no que se refere aos valores obtidos de Na+ e K+ séricos, durante a infusão de ambos os fluidos, não foram observadas alterações que justifiquem a predileção por alguma destas soluções. Diante destes resultados conclui-se que a escolha entre uma das soluções avaliadas não promoveu impacto sob o equilíbrio ácido-base e hidroeletrolítico de pombos submetidos a osteossíntese de úmero...


Subject(s)
Animals , Acid-Base Equilibrium , Sodium Chloride/therapeutic use , Columbidae/surgery , Fracture Fixation, Internal/veterinary , Humeral Fractures/veterinary , Water-Electrolyte Balance , Anesthesia, Inhalation/veterinary , Isoflurane/administration & dosage
18.
Article in Chinese | WPRIM | ID: wpr-746904

ABSTRACT

OBJECTIVE@#To identify the incidence and the risk factors for emergence agitation (EA) in adults undergoing general anesthesia for nasal surgery.@*METHOD@#We examined 674 patients aged ≥ 18 years who underwent general anesthesia for nasal surgery between February 2013 and February 2015. The patients were divided into control group (518 cases) and EA group (156 cases) by Sedation-agitation scale (SAS) method. Demographic and clinical variables were assessed and the data were analyzed by multiple logistic regression analysis.@*RESULT@#The overall incidence of emergence agitation was 23. 15%. Significant difference was observed between EA and the control group in many aspects, such as sex, age, ASA classify, smoking history, history of cerebrovascular disease, preoperative anxiety, the use of midazolam, anesthesia means, postoperative pain, postoperative analgesia, presence of a tracheal tube, and presence of a urinary catheter. The results of multiple logistic regression analysis indicated that the occurring of EA was significantly correlated with younger age, male, preoperative anxiety, inhalation anesthesia, postoperative pain, presence of a tracheal tube, and presence of a urinary catheter, while seniors, with the use of midazolam, total intravenous anesthesia, analgesia and natural awakening were protective factors.@*CONCLUSION@#EA following general anesthesia is a common complication in patients with adult nasal surgery. To reduce the occurrence and consequences of agitation episodes, elimination of the associated risk factors is necessary, especially in patients with risk factors.


Subject(s)
Adult , Age Factors , Analgesia , Anesthesia Recovery Period , Anesthesia, General , Anesthesia, Inhalation , Anxiety , Female , Humans , Incidence , Male , Midazolam , Therapeutic Uses , Nasal Surgical Procedures , Pain, Postoperative , Psychomotor Agitation , Risk Factors
19.
Article in English | WPRIM | ID: wpr-309507

ABSTRACT

<p><b>INTRODUCTION</b>Draw-over anaesthesia remains an attractive option for conduct of anaesthesia in austere conditions. The Diamedica Draw-over Vaporiser (DDV) is a modern draw-over vaporiser and has separate models for isoflurane/halothane and sevoflurane.</p><p><b>MATERIALS AND METHODS</b>A laboratory study was done to measure sevoflurane output in an isoflurane/ halothane DDV. We did 3 series of experiments with the isoflurane/halothane DDV. We measured anaesthetic agent output in both push-over and draw-over setups, and at minute ventilation of 6 L/min and 3 L/min. Series 1 experiment was done with isoflurane in the DDV at ambient temperature of 20°C. Series 2 experiment was done with sevoflurane in the DDV at ambient temperature of 20°C. Series 3 experiment was done with sevoflurane in the DDV and with the DDV placed in a water bath of 40°C.</p><p><b>RESULTS</b>The sevoflurane output was found to be two-thirds of the isoflurane/ halothane DDV dial setting at ambient temperature of 20°C. With the DDV in a 40°C water bath, the sevoflurane output was found to be about the isoflurane/ halothane DDV dial settings.</p><p><b>CONCLUSION</b>In our experiment, we show that it is possible to use sevoflurane in an isoflurane/halothane DDV.</p>


Subject(s)
Anesthesia, Inhalation , Methods , Anesthetics, Inhalation , Halothane , Humans , Isoflurane , Methyl Ethers , Nebulizers and Vaporizers , Temperature
20.
Yonsei Medical Journal ; : 1114-1121, 2015.
Article in English | WPRIM | ID: wpr-150471

ABSTRACT

PURPOSE: The aim of this study was to evaluate the effects of premedication with oral atenolol or enalapril, in combination with remifentanil under sevoflurane anesthesia, on intraoperative blood loss by achieving adequate deliberate hypotension (DH) during orthognathic surgery. Furthermore, we investigated the impact thereof on the amount of nitroglycerin (NTG) administered as an adjuvant agent. MATERIALS AND METHODS: Seventy-three patients undergoing orthognathic surgery were randomly allocated into one of three groups: an angiotensin converting enzyme inhibitor group (Group A, n=24) with enalapril 10 mg, a beta blocker group (Group B, n=24) with atenolol 25 mg, or a control group (Group C, n=25) with placebo. All patients were premedicated orally 1 h before the induction of anesthesia. NTG was the only adjuvant agent used to achieve DH when mean arterial blood pressure (MAP) was not controlled, despite the administration of the maximum remifentanil dose (0.3 microg kg-1min-1) with sevoflurane. RESULTS: Seventy-two patients completed the study. Blood loss was significantly reduced in Group A, compared to Group C (adjusted p=0.045). Over the target range of MAP percentage during DH was significantly higher in Group C than in Groups A and B (adjusted p-values=0.007 and 0.006, respectively). The total amount of NTG administered was significantly less in Group A than Group C (adjusted p=0.015). CONCLUSION: Premedication with enalapril (10 mg) combined with remifentanil under sevoflurane anesthesia attenuated blood loss and achieved satisfactory DH during orthognathic surgery. Furthermore, the amount of NTG was reduced during the surgery.


Subject(s)
Administration, Oral , Adrenergic beta-Antagonists/administration & dosage , Adult , Aged , Anesthesia, Inhalation , Atenolol/administration & dosage , Blood Loss, Surgical , Blood Pressure/drug effects , Cardiac Output/drug effects , Double-Blind Method , Enalapril/administration & dosage , Female , Heart Rate/drug effects , Humans , Intraoperative Care , Male , Methyl Ethers/administration & dosage , Middle Aged , Orthognathic Surgical Procedures , Piperidines/administration & dosage , Premedication , Treatment Outcome
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